Magnetic resonance imaging predicts perianal fistula in Crohn’s disease

doi:10.3748/wjg.116827

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Oct 28, 2026; 32(40): 116827
Published online Oct 28, 2026. doi: 10.3748/wjg.116827

Table 1 Characteristics and outcome of the patients with anal fistulas, mean ± SD/n (%)

Variables	Perianal fistula in CD (n = 69)	Cryptoglandular anal fistula (n = 182)	P value
Age	26.03 ± 7.75	42.70 ± 12.08	< 0.001
Male/female	50/19	158/24	0.007
Duration of anal fistula (month)	14.61 ± 22.09	25.51 ± 49.73	< 0.001
Duration of CD (month)	8.87 ± 18.29	-	-
Previous fistula surgery	32 (46.4)	94 (51.6)	> 0.05
Biological agents (such as anti-tumor necrosis factor)	24 (34.8)	-	-
magnetic resonance imaging feature
Neither transmural inflammation nor active proctitis	12 (17.4)	147 (80.7)	< 0.001
Only transmural inflammation	11 (15.9)	16 (8.8)	< 0.001
Only active proctitis	25 (36.2)	16 (8.8)	< 0.001
Transmural inflammation and active proctitis	21 (30.4)	3 (1.6)	< 0.001

CD: Crohn’s disease.

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Table 2 Receiver-operating characteristic curve analysis of predictive model, n (%)

Predictive model	Perianal fistula in Crohn’s disease (n = 69)	Cryptoglandular anal fistula (n = 182)	Area under the curve	Sensitivity (%)	Specificity (%)	Youden index
Positive	57 (82.6)	35 (19.3)	0.818	82.6	80.7	0.633
Negative	12 (17.4)	147 (80.7)	0.818	82.6	80.7	0.633

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Table 3 Receiver-operating characteristic analysis of predictive model in two periods, n (%)

Period	Perianal fistula in Crohn’s disease	Cryptoglandular anal fistula	Area under the curve	Sensitivity (%)	Specificity (%)	Youden index
Patients in January 2021-December 2021
Positive	23 (82.1)	17 (20.5)	0.808	82.1	79.5	0.616
Negative	5 (17.9)	66 (79.5)	0.808	82.1	79.5	0.616
Patients in January 2022-December 2022
Positive	34 (83.0)	18 (18.2)	0.824	83.0	81.8	0.648
Negative	7 (17.0)	81 (81.8)	0.824	83.0	81.8	0.648

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Table 4 Receiver-operating characteristic analysis of predictive model in the external validation cohort, n (%)

Model 4 (patients in external validation cohort)	Perianal fistula in Crohn’s disease (n = 50)	Cryptoglandular anal fistula (n = 118)	Area under the curve	Sensitivity (%)	Specificity (%)	Youden index
Positive	44 (88.0)	19 (16.1)	0.859	88.0	83.9	0.719
Negative	6 (12.0)	99 (83.9)	0.859	88.0	83.9	0.719

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Citation: Xu ZP, Li L, Sun GD, Wu YY, Cai EW, Wen K, Shao WJ, Chen YG. Magnetic resonance imaging predicts perianal fistula in Crohn’s disease. World J Gastroenterol 2026; 32(40): 116827
URL: https://www.wjgnet.com/1007-9327/full/v32/i40/116827.htm
DOI: https://dx.doi.org/10.3748/wjg.116827

Xu ZP, Li L, Sun GD, Wu YY, Cai EW, Wen K, Shao WJ, Chen YG. Magnetic resonance imaging predicts perianal fistula in Crohn’s disease. World J Gastroenterol 2026; 32(40): 116827 [DOI: 10.3748/wjg.116827]

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